Vanishing Act

It was a summer night during my first year of medical school. Small bugs danced about the school buildings' lights and filled the air with their penetrating hum.

In the television room, located across a small grassy lawn from the dormitories, I sat watching old movies with my classmate and friend Rajesh.

Rajesh was tall and chunky. He wore his thick, jet-black hair combed back, which made his broad face and smile appear even more so. I'd known him since our first days at medical school.

"Everyone in my hometown knows me," Rajesh had told me. "I'm the first one in my area to go to medical school." Clearly he enjoyed being the pride of his small town. Eyes alight, he'd talked about everything he wanted to do for his townspeople once he was a doctor.

Living in a dormitory makes strangers into siblings, and we'd become great friends. During those first euphoric months of medical school, Rajesh, his roommate Bob and I had made a habit of getting together late at night with other classmates to watch old movies on TV.

Those nighttime gatherings had grown less frequent, though, as the year wore on.

This evening, heading to the dorms after dinner, I'd spotted Rajesh watching movies in the television room. I went up to my room and started to read a book, but I couldn't get the image out of my head.

For the past few weeks--maybe even months, I reflected--Rajesh hadn't been himself. Nowadays he mostly kept to himself, didn't talk much. His face looked like Van Gogh's portrait of Dr. Gachet--sad-eyed, weary and thoughtful. It struck me that I hadn't seen him outside his room in weeks.

I closed my book and walked to the television room, intending just say hello and chat for a few minutes, but I ended up staying to watch a couple of old comedy movies. We laughingly traded comments about the actors' wisecracks; Rajesh seemed more cheerful than usual.

As the final credits rolled, I reflected sleepily that it was getting late and stood up to leave.

"We ought to watch more of these," I remarked.

"Sure," Rajesh replied, staring at the screen. I stopped for a moment, looking at him.

"Good night," I said.

"Good night," he replied flatly.

"We've got classes in the morning," I said. "Don't you have to sleep now?"

"I will in a while...Not really sleepy. Just want to watch some more TV," he replied colorlessly, his eyes glued to the screen.

Sitting down in the lecture hall the next morning, I looked around for Rajesh. He wasn't there.

He must be sleeping, I thought.

Around noon, I returned to my room. I lay on my bed, watching the ceiling fan's blades chop through the air.

Suddenly I heard running footsteps in the corridor outside. They got closer.

The door burst open. There stood Bob, pale, panting and breathless. Clutching the door with one hand, he pointed towards the stairs that led up to their dorm room.

"The door is locked...He isn't opening. Come quick!" He ran off.

Heart pounding and mouth dry, I raced after him, a recent conversation with Rajesh replaying in my mind.

We'd been drinking coffee in the cafeteria.

"Do you know the easiest way to die?" Rajesh asked.

The question startled me. I'd seen people die in the hospital, but my own death, or that of anyone I knew, had never crossed my mind.

"I hear it's cyanide," I responded flippantly. "That's what they show in the movies."

"Well, I was reading a forensic medicine book," Rajesh said calmly. "It says hanging is the best way out, if you do it right."

This took me completely off guard. I didn't know what to say. Fear and anger shot through me.

"Look, don't fool around," I said sharply. "If you're trying to crack a joke, you just cracked a really bad one."

Rajesh just looked at me expressionlessly.

The silence felt eerie. A sense of foreboding gripped me.

"Is something bothering you?" I asked.

I waited, but he didn't speak. This silence felt even scarier.

Finally I said, "Do you need help?"

"No, I was just asking out of curiosity," he said quickly. "I don't need help."

I looked at him, unsure what to do. Finally I said, half-kiddingly, "Stop thinking too much." I tried to say the words lightly, but I knew that my fear came through.

Rajesh flashed me an uneasy smile. We sat there silently a few more minutes, then went our separate ways.

That had been two weeks ago. I hadn't mentioned the incident to anyone; it had felt nearly impossible to take Rajesh's question seriously. Other classmates knew, too, that Rajesh was going through a hard time, but we'd all experienced emotional lows; we knew that they don't last forever....

Panting, I reached Rajesh's room. I tried the heavy wooden door. It was bolted from the inside.

I knocked and called, "Rajesh! Rajesh!"

No answer.

I did it again. No answer.

I kicked the door, hard. Another student joined me. We kicked the door again and again, but it wouldn't budge. Then we coordinated our efforts--one-two-three, kick...one-two-three, kick...

Finally, it gave way. We dashed in.

There in the dark, heavily curtained room, I saw my friend's body hanging from a rope knotted around his neck.

I heard someone saying, "What have you done? What have you done?" in a voice that seemed to come from far, far away.

I felt weak and confused, as if I'd suddenly been stricken with the flu. My knees gave way, and I slumped down onto the cold concrete floor.

People began to gather. Someone called the hospital and the police; others just stood there, shocked and terrified.

Over the next few days, as the last rites were performed for Rajesh and the initial shock started to fade, I thought about the consequences of his tragic act.

I had lost a friend. And the world had lost a future doctor, who would have helped hundreds of people over the course of his career.

Rajesh's mother and father had dreamed of seeing their son become a doctor. The people in his hometown had dreamed that one of their own would return to take care of them.

None of that would happen now.

This experience has changed me--as a person and as a doctor.

Looking back, I feel that I might have done more to help Rajesh. Grief and guilt hung over me like a dark cloud for many months.

Rajesh's tragic death taught me that life is beautiful but unpredictable. Every moment is everlasting, each breath invaluable. I learned the importance of "here and now." And as a doctor, I believe that I hear more clearly what people say--and what they don't say. Their subtle expressions of pain and suffering resonate within me much more profoundly.

In the future, I hope to be able to see and heal not just the physical symptoms of illness but also the emotional anguish that comes with being sick. I hope to look beyond the pathology; I've learned how important it is to recognize and heal the person.

About the author:

Having completed a research fellowship at Massachusetts General Hospital, Sudeep last month started his internal-medicine residency at Henry Ford Hospital, in Detroit, MI. "I am generally interested in scientific writing, and this is my first literary publication. Writing helps me to communicate with a wider audience about issues that are important to me. Turning ideas into words is a beautiful process, and I love it."